2026 Star Ratings Cut Points Cheat Sheet | Pelica Health
Short answer
This is a free, printable cheat sheet on how CMS sets Medicare Star Ratings cut points: the per-measure thresholds that turn a score into 1 to 5 stars. It covers Tukey outlier deletion, the 5 percentage point guardrail, and the Reward Factor, and includes a worksheet to plan the glide path to 4 stars. Print it or save it as a PDF.
Cut points are the thresholds CMS sets each year to turn a measure's score into a 1 to 5 star rating. Because CMS sets them from the distribution of every contract's score, no plan knows the exact cut point in advance, so quality teams plan to a margin. This cheat sheet is free to print or save as a PDF, no email required.
Print or save as PDF
How CMS sets cut points
The mechanics, in four steps
- Collect the field. CMS takes every contract's score for a measure.
- Remove outliers (Tukey). For non-CAHPS measures, CMS deletes scores outside 3.0 times the interquartile range below the first quartile or above the third quartile.
- Cluster. A clustering algorithm groups the remaining scores into five bands, which become the 1 to 5 star thresholds.
- Apply the guardrail. A cut point cannot move more than 5 percentage points from the prior year for most non-CAHPS measures.
The terms on one page
| Term | What it means |
|---|---|
| Cut point | The score threshold that earns a given star level for a measure. |
| Tukey outlier deletion | Removes extreme outlier contract scores (3.0x IQR fences) before clustering, which stabilizes cut points year to year. |
| Guardrail | Caps year-over-year cut-point movement at 5 percentage points for most non-CAHPS measures. |
| Reward Factor | An adjustment of up to 0.4 added for consistently high performance with low variance. Applies for the 2026 Star Year. |
| EHO4all (2027) | The Excellent Health Outcomes for All adjustment, previously the Health Equity Index, replaces the Reward Factor starting Star Year 2027 and phases in at a smaller initial value. |
For the 2026 Star Year detail, see the 2026 Star Ratings cut points explainer; for what changes next year, see the 2027 Star Ratings changes.
Glide-path planning worksheet
List your priority measures, last year's 4-star cut point, your current rate, and the gap to close. Add the 5-point guardrail to last year's cut point to set a safe target, since the real cut point can move up that far.
| Measure | Weight | Prior 4-star cut point | Your current rate | Gap to target |
|---|---|---|---|---|
Prioritize the triple-weighted measures first, since a few points there move the summary rating more than almost any other lever.
How Pelica helps you hit the cut point
The hard part is not knowing the cut point. It is closing enough gaps, on the right members, before the measurement year ends. Most platforms show the gap list. Pelica's Quality and Stars copilot forecasts the glide path to each cut point, flags the members who can still move the measure, and closes the loop from outreach to a sourced, scorable result. Across deployments, customers close about 90% of BCS and KED gaps in-year and 70% or more of transitions-of-care gaps within 30 days.
Sources
- CMS: 2026 Part C & D Star Ratings Technical Notes
- CMS: 2026 Star Ratings Fact Sheet
- 42 CFR 423.186: Calculation of Star Ratings
Frequently asked questions
Common questions about Star Ratings cut points and this cheat sheet.
What are Star Ratings cut points?
Cut points are the score thresholds CMS sets each year that determine how many stars a measure earns, from 1 to 5. CMS sets them from the distribution of all contracts' scores for that measure, so a plan does not know the exact cut point until the ratings are released.
What is Tukey outlier deletion?
Tukey outlier deletion is the step CMS applies to non-CAHPS measures before setting cut points. It removes contract scores that fall outside 3.0 times the measure's interquartile range below the first quartile or above the third quartile, then clusters the remaining scores. Removing extreme outliers makes cut points more stable year to year.
What is the Star Ratings guardrail?
The guardrail caps how far a cut point can move from one year to the next at 5 percentage points for most non-CAHPS measures. It prevents large year-over-year swings, which is why plans plan to a margin above the prior year's cut point plus the guardrail.
Is this cheat sheet free?
Yes. The cheat sheet is free to print or save as a PDF, with no email required. It summarizes how CMS sets cut points and includes a worksheet to plan your glide path to 4 stars.
Plan to the cut point. Then actually close the gaps.
Pelica's Quality and Stars copilot forecasts the glide path to each cut point and closes the loop from outreach to a sourced result. Customers close about 90% of BCS and KED gaps in-year, on one record across every contract.